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Family Plan World. 1992 Jan-Feb;2(1):10-1, 31.

IUDs struggle to shake off legacy of past.



Despite the wealth of evidence supporting the safety and efficacy of IUDs, fears of health problems associated with use of the device still linger in the US. Over the past 10 years, studies have shown that a new class o IUDs, copper-bearing IUDs, result in fewer pregnancies than oral contraceptives, and are as effective as Norplant, the long-acting hormonal implant. Additionally, the new class of IUDs have significantly lowered the rate of complications associated with use, complications such as bleeding, discomfort, and involuntary expulsion. Some experts say that the IUDs are among the most effective and safest forms of contraception available. And while the popularity of IUDs continues to rise in Europe and Asia, only an estimated 1% of US women use IUDs. Fears over IUD use in the US stem from the Dalkon Shield debacle in the 1980s, when reports about infection and infertility associated with the use of this particular type of IUD began to surface. More than 100,000 women filed a class action suit against Dalkon Shield's manufacturer, A.H. Robbins, and fear of similar liability prompted competing manufacturers to withdraw IUDs from the market. From 1986-88, only one type of IUD could be found in the US market. Experts now say that the safety questions -- especially concerns over the risk of pelvic infections -- about IUDs no longer apply, so long as the devices are properly prescribed and inserted under thoroughly aseptic conditions. Although the number of US women using IUDs is small, the IUD enjoys the highest satisfaction rate of any contraceptive method, 98%. Nonetheless, a comeback in the US for IUDs remains unlikely at this time, since the majority of women still distrust of the method, and physicians remain fearful of liability risks.

[Indexed for MEDLINE]

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